Provider Demographics
NPI:1679570501
Name:NEE, DOUGLAS (PHARMD, MS)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:
Last Name:NEE
Suffix:
Gender:M
Credentials:PHARMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 E WESTMINSTER AVE
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84108-3209
Mailing Address - Country:US
Mailing Address - Phone:858-248-2128
Mailing Address - Fax:
Practice Address - Street 1:10625 MATHIESON ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92129-3418
Practice Address - Country:US
Practice Address - Phone:858-248-2128
Practice Address - Fax:858-672-2463
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH558741835P1200X
FLPS180131835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy